The development of Information technology affects the medical field a lot. Even though the PACS is developed for filmless hospital, the initial cost is very high and the investment effect is not clear yet. The purpose of this paper is to develop a costeffective hospital PACS which can be integrated with existing hospital information systems. Even though the PACS is developed for small sized hospitals, it has all the important functions of the large-scaled PACS system can provide such as image processing, clinic and patient information management, image file transfer through communication, and report generator functions for various types of hard output. Also, the developed system is designed for future expansion and compatibility with other hospital information systems.